The markings of fetal alcohol syndrome include
■ abnormal growth in height, weight, and/or head circumference, in- cluding microcephaly;
■ central nervous system problems such as behavioral and/or mental health problems, including learning disabilities and abnormal sleeping and eating patterns; and
■ appearance with a specific pattern of recognizable deformities, such as the three key facial features, a smooth philtrum, a thin vermillion border, and small palpebral fissures. (Bertrand, Floyd, & Weber, 2005, p. 3).
An estimated 70,000 fetal alcohol children are born every year in the United States, many of whom are American Indians. The worldwide numbers vary, with a range of 0.2–1.5 cases per 1,000 live births being most frequently
HEALTH and ILLNESS in the American Indian and Alaska Native Population ■ 227
reported (Bertrand et al., 2005, p. 3). Dorris (1989, p. 231) further points out that the son of an alcoholic biological father is 3 times more likely to become an abusive drinker.
This problem has grown over time, and the impact increases with each gen- eration. Mortality and morbidity rates for American Indians are directly affected by alcohol abuse. Alcohol abuse is the most widespread and severe problem in the American Indian community. It is extremely costly to the people and underlies many of their physical, mental, social, and economic problems, and the problem is growing worse. Hawk Littlejohn, the medicine man of the Cherokee nation, Eastern band, attributes this problem, from a traditional point of view, to the fact that American Indians have lost the opportunity to make choices. They can no longer choose how they live or how they practice their medicine and religion. He believes that, once people return to a sense of identification within themselves, they begin to rid themselves of this problem of alcoholism. Whatever the solution may be, the problem is indeed immense (Littlejohn, 1979).